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Old 04-04-2013
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Default Cushings syndrome question

When you suspect Cushings Syndrome, which is the best initial test to do? Is it the Dexamethasone suppression test or the 24 hour urinary free cortisol?

I'm confused because while Kaplan says do Dexa suppression first, and if abnormal do 24 hour urinary cortisol, MTB 2 says do 24 hour urinary cortisol first.
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Old 04-04-2013
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Originally Posted by rohit39 View Post
When you suspect Cushings Syndrome, which is the best initial test to do? Is it the Dexamethasone suppression test or the 24 hour urinary free cortisol?

I'm confused because while Kaplan says do Dexa suppression first, and if abnormal do 24 hour urinary cortisol, MTB 2 says do 24 hour urinary cortisol first.
i think it's 24hr free urinary cortisol level is the initial and also specific too than 1mg DST.....(uworld has similar kinda question)......
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Old 04-04-2013
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Oh cool, thanks! I'll keep that in mind.
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Originally Posted by rohit39 View Post
Oh cool, thanks! I'll keep that in mind.
that's okay....actually i also dont know why it's more specific and initial test...i mean though it's accurate ,it'll take time and sometimes difficult to catch 24hr urine free cortisol level....1mg overnight DST is easy to do i guess.....anyways i cant judge those books though.....
let's wait some more explanations too.....goodluck
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